Orthopedic ladies' depth shoes at Fairview Maple Grove Surgery Center

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
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Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Orthoped ladies shoes dpth i

Maple Grove, MN

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Pricing by billing methodology

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How this price compares nationally

Fairview Maple Grove Surgery Center’s median price of $95 is 14% below the median hospital's median price ($111), higher than 42% of the 383 hospitals reporting HCPCS L3216. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS L3216 at Fairview Maple Grove Surgery Center

Negotiated rates from the hospital’s own file: 4 payers, 16 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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#
1	Blue Cross Blue Shield federal fee schedule · outpatient	$32	$32	—	—	—	$32 – $32
2	Blue Cross Blue Shield commercial fee schedule · outpatient	$33	$33	—	—	—	$33 – $33
3	Blue Cross Blue Shield medicaid fee schedule · outpatient	$33	$33	—	—	—	$33 – $33
4	Blue Cross Blue Shield federal fee schedule · both	$33	$33	—	—	—	$33 – $33
5	Blue Cross Blue Shield commercial fee schedule · both	$33	$33	—	—	—	$33 – $33
6	Medica ma non-snp fee schedule · both	$82	$82	—	—	—	$82 – $82
7	Medica ma snp fee schedule · both	$82	$82	—	—	—	$82 – $82
8	Medica prime solution fee schedule · both	$82	$82	—	—	—	$82 – $82
9	Medica vantage fee schedule · both	$82	$82	—	—	—	$82 – $82
10	Cigna commercial fee schedule · both	$104	$104	$9	9%	—	$95 – $113
11	Medica bold fee schedule · both	$148	$148	—	—	—	$148 – $148
12	Medica choice without / elect fee schedule · both	$165	$165	—	—	—	$165 – $165
13	Medica city of st paul / essential uplan fee schedule · both	$165	$165	—	—	—	$165 – $165
14	Medica choice with fee schedule · both	$170	$170	—	—	—	$170 – $170
15	UnitedHealthcare commercial fee schedule · both	$217	$217	—	—	—	$217 – $217
16	Cigna commercial fee schedule · outpatient	$219	$219	$19	9%	—	$200 – $238

Last updated: May 18, 2026

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